Transgender groups are encouraging teenagers to use their ‘gender-change’ certificates to access sex-change treatments abroad, a leading Irish doctor has warned. Professor Donal O’Shea who works with adults and teenagers suffering gender dysphoria and who directs sex-change treatments told the Irish Mail on Sunday that Irish doctors are not concerned about people ‘self-declaring’ their new gender. However, “what is of concern is the potential use of the certificate as a passport to treatment that involved major hormonal manipulation and surgery, and we are already aware it is occurring, particularly in Poland where patients are told ‘Bring your cert.’” Medical professionals are concerned that, absent a psychiatric assessment, many more adults and teenagers may regret the changes that are irreversible.